Abstract: The catechol-O-methyltransferase COMT enzyme is critical for the catabolic regulation of synaptic dopamine, resulting in altered cortical functioning. The COMT Val158Met polymorphism has been implicated in human mental illness, with Met-Met homozygotes associated with increased susceptibility to posttraumatic stress disorder PTSD. Our primary objective was to examine the intermediate phenotype of fear inhibition in PTSD stratified by COMT genotype Met-Met, Val-Met, and Val-Val and differential gene regulation via methylation status at CpG sites in the COMT promoter region. More specifically, we examined the potential interaction of COMT genotype and PTSD diagnosis on fear-potentiated startle during fear conditioning and extinction and COMT DNA methylation levels as determined using genomic DNA isolated from whole blood. Participants were recruited from medical and gynecological clinics of an urban hospital in Atlanta, Georgia. We found that individuals with the Met-Met genotype demonstrated higher fear-potentiated startle to the CS-safety signal and during extinction of the CS+ danger signal compared to Val-Met and Val-Val genotypes. The PTSD+ Met-Met genotype group had the greatest impairment in fear inhibition to the CS-p=.006, compared to Val carriers. In addition, the Met-Met genotype was associated with DNA methylation at 4 CpG sites, 2 of which were associated with impaired fear inhibition to the safety signal. These results suggest that multiple differential mechanisms for regulating COMT function - at the level of protein structure via the Val158Met genotype and at the level of gene regulation via differential methylation - are associated with impaired fear inhibition in PTSD.

This work was funded in part by the Brain and Behavior Foundation formerly NARSAD; Seth Davin Norrholm; and Tanja Jovanovic, and the Department of Defense DOD-Congressionally Directed Medical Research Program CDMRP, Award # W81XWH-08-2-0170; PI, Seth Davin Norrholm.

This work was also supported by the Max Planck Society and the Doris Duke Charitable Foundation Elisabeth Binder.